Primary Cutaneous Granulomatous Phlebitis of the External Jugular Vein
Design: Case report. Setting: Department of Otolaryngology and Head and Neck Surgery, St. John's Medical College Hospital, India. Patient: A 22-year-old man with a cord-like neck mass of 6 months' duration. Investigations and intervention: Investigations included Doppler ultrasound of the neck, which showed thrombosis of the right external jugular vein. Wedge biopsy revealed a granulomatous inflammation with focal necrosis completely replacing the vessel. Serological testing for vasculitides was negative. Transcervical excision of the vein was carried out after identifying normal vessel distally and proximally. Histopathological examination of the vein proved the lesion consistent with primary cutaneous granulomatous phlebitis (PCGP). Conclusion: Isolated venous inflammatory diseases with neither identifiable active vasculitis nor arteritis are rarely seen. PCGP is distinctly unusual. We report a case of PCGP of the external jugular vein presenting as an elongated cord-like nodular lesion in the lateral neck of insidious onset.